Provider Demographics
NPI:1962742031
Name:NEW BEGINNINGS HEALTH CARE, A PROFESSIONAL MEDICAL CORPORATION
Entity type:Organization
Organization Name:NEW BEGINNINGS HEALTH CARE, A PROFESSIONAL MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:DECKERT
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:619-713-5540
Mailing Address - Street 1:8911 LA MESA BLVD STE 101
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-9000
Mailing Address - Country:US
Mailing Address - Phone:619-713-5540
Mailing Address - Fax:
Practice Address - Street 1:8911 LA MESA BLVD STE 101
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-9000
Practice Address - Country:US
Practice Address - Phone:619-713-5540
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-26
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA20A6289OtherMEDICAL LICENCE
CAF13283OtherUPIN